Don't worry -- It isn't that bad

JENNIFER WILLIAMS247-4644

Doctors recommend that every woman should get her first mammogram at age 35 to provide a baseline for future screenings, but I had blown it off two years running. Just as I was about to toss out the prescription my nurse practitioner gave me at my annual physical, I walked past the TV and got prodded.

A morning news show had a segment about October being breast cancer awareness month and the importance of getting mammograms to catch the disease early. Then my mom, a nurse her entire adult life, answered my e-mail the opposite of how I wanted her to, saying she thought I needed to go ahead and get in there.

I decided to make the appointment. I consulted a friend, who writes about health matters in our newspaper, about the potential benefits of a frank, first-person look at the experience.

My logic was there are a lot of people like me out there -- women who could benefit from undergoing a mammogram but are afraid because they've heard horror stories. After asking another coworker about the wisdom of discussing such matters in print, and being assured it was a good idea, I pushed my fears aside.

If there's a growth, a mammogram is the best way to detect it while it's still small enough to be harmless. Hopefully, though, I'd come out with peace of mind because I'd know nothing was wrong. I'd also know what to expect next time.

There's a lot of bad information out there, and not a lot of real, nitty-gritty details. Women hear vague references to "smushing," cold metal plates and extreme pain. None of that makes anyone want to ask for more specifics.

Well, here goes.

When I called for my appointment, I was told not to wear any powder, deodorant, lotion or perfume. If you try to smell good, they have wipes to get rid of that stuff after you arrive.

These substances can appear as misleading images on the X-rays.

I wasn't too worried until the weekend just before the appointment, when I kept seeing it on my calendar. In the waiting room, I had sweaty palms and noticed the rest of the women looked much older than me.

One of them was less than helpful. When she asked if I was waiting to have a mammogram done, as she was, I said it was my first. She groaned and started talking about plates "slamming" down on you.

Great.

When I went back for my test, an assistant put me in a dressing room. She told me to undress from the waist up and put on a gown that opened at the front and tied shut. After a short wait, a technician came to get me and took me into the room where the tests are taken. She asked me if anybody had explained to me what's actually done.

I answered that they had not.

The machine looks like a standard X-ray machine, with a plastic shelving-looking part at the front. She said that essentially she would take four pictures, one from the top and one from the side on each breast.

The technician told me how I would have to be positioned and that I'd have to hold my breath while the images were being taken. She added that if it hurt too badly, I should say something and she would adjust the machine.

I had been told this is one of the few cases in life where having less in this particular area is actually to your advantage. But apparently it varies solely based on your pain tolerance and level of sensitivity.

The object is to get the breasts as flat as possible, using plates from the top and sides. I stood in front of the machine, leaning inward. For the side shots, I had to put my arms across a little handle so that my armpits and their lymph nodes were included.

It is not bad at all. If it was, I promise you'd be reading it here right now.

Though the plates do press hard, it is only for a few seconds while the shot is being taken and then they release you immediately. The pressure isn't anywhere close to excruciating. The technician did have to get me positioned, but they're used to doing this and it was minimally embarrassing.

The plates are actually plastic, and not particularly cold. I wasn't in any of the body positions long enough to get stiff or uncomfortable.

Afterward, I waited in the room while they developed the films to make sure they turn out OK. My wait was about 10 minutes. One of my pictures had to be redone, but it took just a few additional seconds.

After a little more wait time to make sure the reshoot was OK, I was released to get dressed and go. I could expect to receive my results in about a week.

My deodorant was waiting in my work bag, so I could put it on before going into the office where I'm sure it was much appreciated.

All joking aside, this test is important and it's our best method of catching breast cancer in its earliest stages. So I encourage anybody who's waffling to go ahead and get in there.

After all, that's why I'm writing about this in the newspaper.

BREAST CANCER AND MAMMOGRAMS

* Breast cancer is the most common cancer among women, other than skin cancer. It is the second leading cause of cancer death in women, after lung cancer.

* About 211,240 women in the United States -- roughly 6,350 in Virginia -- will be found to have invasive breast cancer every year. About 40,410 women will die from the disease. The chance of a woman having invasive breast cancer some time during her life is about 1 in 8. The chance of dying from breast cancer is about 1 in 33, although death rates are falling thanks to early detection and better treatment.

* Women should have a baseline mammogram at age 35 and at age 40 and older should have a mammogram every year and should continue to do so for as long as they are in good health, according to the American Cancer Society. A primary care doctor can write a prescription. People with a family history of breast cancer should talk with their doctor about starting mammograms at a younger age.

* Women in their 20s and 30s should have a clinical breast exam as part of a regular exam by a health expert, preferably every three years. During those appointments, ask a doctor or nurse how to do monthly self-exams at home. n See a doctor right away if you notice any of these breast changes: a lump or swelling, skin irritation or dimpling, nipple pain or the nipple turning inward, redness or scaliness of the nipple or breast skin, or a discharge other than breast milk.

* The Virginia Breast and Cervical Cancer Early Detection Program -- also known as Every Woman's Life -- offers free mammograms and clinical breast exams, as well as Pap tests and pelvic exams, to women who lack health coverage and meet certain age and income requirements. Locally, both Riverside Health System (1-800-520-7006) and the Hampton Health Department (727-1140) are involved in the program.